头孢他啶阿维巴坦对耐碳青霉烯类肺炎克雷伯菌的体外抗菌活性分析

Antibacterial activity of ceftazidime-avibactam against carbapenem-resistant Klebsiella pneumoniae in vitro

目的探讨头孢他啶阿维巴坦(CAZ-AVI)对耐碳青霉烯类肺炎克雷伯菌(CRKP)的体外抗菌活性。方法选取2019年1月至2020年12月空军军医大学第二附属医院临床各科室送检标本分离的肺炎克雷伯菌1 075株,进行细菌鉴定及药物敏感性试验。结果在1 075株肺炎克雷伯菌中CRKP共检出168株,检出率为15.6%,碳青霉烯类敏感肺炎克雷伯菌检出907株,检出率为84.4%。CRKP菌株对多黏菌素B敏感,对CAZ-AVI和替加环素的耐药率分别为14.3%(24/168)和3.6%(6/168),而对头孢吡肟和哌拉西林他唑巴坦的耐药率均为99.4%(167/168)。168株CRKP检测出产bla_(KPC)144株(85.7%)、产bla_(NDM-1)22株(13.1%)和产bla_(KPC+NDM)双酶2株(1.2%)。结论 CAZ-AVI对CRKP具有良好的体外抗菌效果,为临床有效治疗CRKP感染带来了新的选择。

Objective To discuss the antibacterial activity of ceftazidime-avibactam(CAZ-AVI) against carbapenem-resistant Klebsiella pneumoniae(CRKP) in vitro. Methods From January 2019 and December 2020, 1 075 strains of Klebsiella pneumoniae(KP) isolated from specimens of clinical departments in the Second Affiliated Hospital of Air Force Medical University were identified and were performed drug susceptibility test. Results Among 1 075 strains of KP, 168 strains of CRKP were detected, with the detection rate of 15.6%, and 907 strains of carbapenem sensitive KP were detected, with the detection rate of 84.4%. CRKP strains were sensitive to polymyxin B, and the drug resistance rates to CAZ-AVI and tegacyclin were 14.3%(24/168) and 3.6%(6/168), respectively, while the drug resistance rate to cefepime and piperacillin/tazobactam were both 99.4%(167/168). The detection of bla_(KPC), bla_(NDM-1) and bla_(KPC+NDM) double enzymes in 168 strains of CRKP were 144 strains(85.7%), 22 strains(13.1%) and 2 strains(1.2%), respectively. Conclusion CAZ-AVI is high effective against CRKP in vitro, which brings a new option for clinically treatment of CRKP.